特定的损伤会造成特定的后果。 虐待性头部创伤 (AHT) 的死亡率较高。 约 20% 到 30% 的 AHT 儿童受害者死于这些损伤,约三分之二患儿会存活,但会造成显著性长期残疾,包括神经系统、行为及认知后遗症。[67]Chiesa A, Duhaime AC. Abusive head trauma. Pediatr Clin North Am. 2009;56:317-331.http://www.ncbi.nlm.nih.gov/pubmed/19358918?tool=bestpractice.com AHT 患儿的治疗效果比意外性头部创伤患儿的治疗效果差,住院时间更长且发病率更高。[19]Vinchon M, Defoort-Dhellemmes S, Desurmont M, et al. Accidental and nonaccidental head injuries in infants: a prospective study. J Neurosurg. 2005;102(4 Suppl):380-384.http://www.ncbi.nlm.nih.gov/pubmed/15926388?tool=bestpractice.com[164]Keenan HT, Runyan DK, Marshall SW, et al. A population-based comparison of clinical and outcome characteristics of young children with serious inflicted and noninflicted traumatic brain injury. Pediatrics. 2004;114:633-639.http://www.ncbi.nlm.nih.gov/pubmed/15342832?tool=bestpractice.com 与意外腹部创伤相比,虐待性腹部损伤的结局显著较差,致死率显著较高。[165]Lane WG, Lotwin I, Dubowitz H, et al. Outcomes for children hospitalized with abusive versus noninflicted abdominal trauma. Pediatrics. 2011;127:e1400-e1405.https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3103272/http://www.ncbi.nlm.nih.gov/pubmed/21555490?tool=bestpractice.com 重度浸没式烫伤会导致约 10% 死亡率。 在各种形式的儿童虐待中,忽视最常导致死亡,原因为饥饿、缺乏必要的医学治疗或缺乏适当监督。
受虐儿童会因成人忽视表现出各种消极后果,包括酗酒、毒品使用及犯罪行为等高危行为。[8]Gilbert R, Spatz Widom C, Browne K, et al. Burden and consequences of child maltreatment in high income countries. Lancet. 2009;373:68-81.http://www.ncbi.nlm.nih.gov/pubmed/19056114?tool=bestpractice.com[166]Danese A, Moffitt TE, Harrington H, et al. Adverse childhood experiences and adult risk factors for age-related disease: depression, inflammation, and clustering of metabolic risk markers. Arch Pediatr Adolesc Med. 2009;163:1135-1143.http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3560401/http://www.ncbi.nlm.nih.gov/pubmed/19996051?tool=bestpractice.com[167]Wegman HL, Stetler C. A meta-analytic review of the effects of childhood abuse on medical outcomes in adulthood. Psychosom Med. 2009;71:805-812.http://www.ncbi.nlm.nih.gov/pubmed/19779142?tool=bestpractice.com[168]Rivera B, Widom CS. Childhood victimization and violent offending. Violence Vict. 1990;5:19-35.http://www.ncbi.nlm.nih.gov/pubmed/2278946?tool=bestpractice.com 任何形式的儿童虐待(精神、身体或性虐待、忽视)还与成人时期心理健康问题增多有关。这可能包括抑郁症、创伤后应激障碍、药物滥用或反社会型人格障碍。[8]Gilbert R, Spatz Widom C, Browne K, et al. Burden and consequences of child maltreatment in high income countries. Lancet. 2009;373:68-81.http://www.ncbi.nlm.nih.gov/pubmed/19056114?tool=bestpractice.com[169]Luntz BK, Widom CS. Antisocial personality disorder in abused and neglected children grown up. Am J Psychiatry. 1994;151:670-674.http://www.ncbi.nlm.nih.gov/pubmed/8166307?tool=bestpractice.com 儿童虐待还与多种成人时期身体健康预后不良有关,包括肥胖、癌症、心脏病及肺疾病。此外,一些研究正在评估儿童虐待和忽视所致的成人时期身体健康结果的表观遗传机制。[170]Yang BZ, Zhang H, Ge W, et al. Child abuse and epigenetic mechanisms of disease risk. Am J Prev Med. 2013;44:101-107.http://www.ajpmonline.org/article/S0749-3797(12)00797-0/fulltexthttp://www.ncbi.nlm.nih.gov/pubmed/23332324?tool=bestpractice.com[171]Leeb RT, Lewis T, Zolotor AJ. A review of physical and mental health consequences of child abuse and neglect and implications for practice. American Journal of Lifestyle Medicine. 2011;5:454-458.
受虐儿童的受教育程度也较低,在需接受特殊教育支持的儿童中比例过大。[8]Gilbert R, Spatz Widom C, Browne K, et al. Burden and consequences of child maltreatment in high income countries. Lancet. 2009;373:68-81.http://www.ncbi.nlm.nih.gov/pubmed/19056114?tool=bestpractice.com[172]Perez CM, Widom CS. Childhood victimization and long-term intellectual and academic outcomes. Child Abuse Negl. 1994;18:617-633.http://www.ncbi.nlm.nih.gov/pubmed/7953902?tool=bestpractice.com 受虐幸存者的长期财务前景也比非受虐儿童的差。[8]Gilbert R, Spatz Widom C, Browne K, et al. Burden and consequences of child maltreatment in high income countries. Lancet. 2009;373:68-81.http://www.ncbi.nlm.nih.gov/pubmed/19056114?tool=bestpractice.com